Endometrial cancer: diagnosis and treatment

Every year in many countries, the incidence of endometrial cancer. He ranked 3rd among all other types of cancer, which is approximately 30%. In most cases, cancer of the endometrium of the uterus occurs in women after age 60.

The mechanism of development and the reasons

Called uterine cancer atypical cells that occur in the mucosa of the endometrium. The most basic cause of this disease is the excess of hormone estrogen and lack of progesterone in a woman's body.

The malignancy may also develop mucous membrane of the uterus, if it is growing continuously. For the development of endometrial cancer affected the women age. The older a woman is, the more likely she is to get sick.

Risk factors include the following States:

1) diabetes mellitus;

2) infertility;

3) obesity;

4) menopause (late);

5) lack of labor;

6) the use of tamoxifen.

The tumor process can be localized in different parts of the uterus, but most often selects the top division. In rare cases, the tumor arises in the inner uterine throat.

In medical practice there are two pathogenetic types: hormone-dependent and Autonomous. For hormone-dependent type, characterized by the development of the patient's endocrine and metabolic disorders, lack of ovulation, diabetes. For an offline variant is characterized by the absence of signs of endocrine and metabolic disorders.

The structure of the tumor

At the macroscopic study of malignancy usually appears as exophytic tumor with a broad base. It may occupy the entire uterine cavity, or even stretch it. If malignancy infiltrating, in such cases, the tumor can grow in the uterine wall at different depths, from the myometrium and to the serosa of the shell. Endometrial cancer develops in most cases as adenocarcinoma, which makes up about 75% of all pathology.

The process of tumor spread through hematogenous, through the lymphatic vessels (lumbar). Primarily affects the epididymis, and then at a later date parametrilla fiber. Metastases can appear in the lungs and damage the vagina. In the late stages affects the bones and kidneys, and other organs and tissues.

To particularly aggressive forms of endometrial cancer of the uterus include the clear cell type of cancer, and serous-papillary type. In very rare cases you can meet the squamous type of cancer.

Signs

The most common symptoms of endometrial cancer are considered to be spotting from the genital tract or Beli. They can occur regardless of the menstrual cycle and even during menopause. This symptom is most typical for older women and allows you to suspect a malignant process even in the earliest stages of development. Allocations are liquid with mucus or purulent, malodorous, color of meat slops. Sometimes occur for no reason heavy bleeding, they are in 90% of cases.

Much less can experience pain in the lower abdomen. The development of this symptom is associated with tumor growth and increase of the uterus, and as a result of compression of the internal organs. If the tumor presses on nerve endings in the pelvic area, the patient can be distressing gnawing or aching pain, especially at night. Mostly pain or any other symptoms occur, usually when the cancer has already spread through the body and has metastasized.

The formation of pyometra or hematometra. In the uterine cavity accumulates blood and pus. Most often, this symptom manifests in the elderly. The prognosis of thisthe condition is extremely unfavorable.

Of the other symptoms of endometrial cancer, the formation of constipation or dysfunction of urination. This is due to the growth of the tumor and its pressure on other organs, namely the rectum and the region of the bladder.

To the obvious signs of cancer of the endometrium of the uterus can also be attributed to the presence of dense tumor formation in the abdomen during palpation examination. In the future, there is General deterioration: fatigue, weakness, nausea, anemia, dizziness and other symptoms.

Diagnosis

To determine the presence of endometrial cancer in several ways:

1) Histological examination. To do this, from the affected area taken scrapings, which will show the presence of atypical cells, if any, and the type of malignancy.

2) Fluorescent diagnostics. Refers to modern methods of examination of cervical cancer. Is carried out using light radiation on the tumor.

3) Photodynamic diagnosis. This method of survey allows to detect the borders of the tumor itself pathological focus.

4) Ultrasound examination. Ultrasound endometrial cancer is one of the main types of survey. Ultrasound diagnosis performed abdominal or vaginal method.

5) Cytological method. Allows you to explore the cellular structure of the tumor. Possible multiple diagnostics by this method.

6) Servicehistory. Provides an opportunity to assess the prevalence of cancer in the body of the uterus.

The ultrasonic examination allows to detect the presence of malignant neoplasms at any age. Ultrasound endometrial cancer gives an opportunity to define the contours of the tumor, its size and structure. Endometrial cancer should be differentiated from endometrial polyp, and submucous GGE MM.

The most informative method of diagnosis of cancer of the uterus is hysteroscopy. Other diagnostic methods include bimanual examination, the clinical history and x-ray diagnostics.

Stage

There are stages of uterine cancer:

Stage 1 – the tumor extends beyond the uterus;

Stage 2 – malignant tumor moves to the cervix, but not beyond the endometrium;

Stage 3 – there is tumor spread to the pelvic area;

Stage 4 – characterized by the germination of malignancy in the rectum or the bladder are metastases.

Treatment

Cancer treatment of endometrial cancer conducted a comprehensive, in several stages:

1) surgical treatment;

2) radiation therapy;

3) chemotherapy;

4) hormonal.

Surgery is the most important and the first method of treatment of cancer of the uterus. For this the patient removed the body of the uterus, appendages and neck. Depending on the severity of the process may also remove the omentum, and regional lymph nodes.

After radical surgical treatment is radiation therapy. Distinguish between remote and intracavitary therapy.

Chemotherapy is carried out in the case of the spread of the tumor to other tissues and organs, as well as complications and relapses. With this purpose, widely used drugs such as Cisplatin and Doxorubicin in various combinations.

Hormonal therapy is carried out only in cases of lack of efficacy of previous treatments. It includes drugs Faslodex, Tamoxifen, and others, comprising a progestogen. Treatment must be carried out in hospital under the supervision of experienced medical professionals.

Prognosis endometrial cancer

Whether favorable prognosis, depends entirely on the stage of cancer of the uterus, its type and extent of the tumor. If the diseaseidentified at an early stage, in the presence of high-grade tumors the survival rate would be about 95%. Survival with low-grade tumor is about 18%.

For stage 4 endometrial cancer typical five-year survival in 35% of cases, provided that the malignant vysokomehanizirovannoe. At all stages of uterine cancer five-year survival is about 75%. The sooner you get treatment, the greater the chances for a full recovery. Approximately 50% of patients have a repeated progression of tumor process during the first two years after treatment.

It is therefore recommended that patients undergo diagnosis first three years after treatment, every 6 months. This ultrasonic diagnosis, a pelvic examination, radiographic examination method, and others. Such preventive measures will help to detect any changes and take action to eliminate them.